The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?

Serum potassium level of 3.8 mEq/L (3.8 mmol/L)

Hemoglobin level of 13.5 g/dL (135 g/L).

Serum glucose level of 120 mg/dL (6.7 mmol/L)

Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)

Answer and Explanation

The Correct Answer is A

Choice A rationale

Sodium polystyrene sulfonate is a medication used to treat high levels of potassium in the blood, a condition known as hyperkalemia. Hyperkalemia is a common complication of acute kidney injury (AKI). The medication works by exchanging sodium ions for potassium ions in the intestine, which are then excreted from the body. Therefore, a decrease in serum potassium levels to within the normal range (3.5-5.0 mEq/L) would indicate that the medication has been effective.

Choice B rationale

Hemoglobin levels are not directly affected by sodium polystyrene sulfonate. Hemoglobin is a protein in red blood cells that carries oxygen. While it’s an important indicator of overall health, changes in hemoglobin levels would not indicate whether treatment for hyperkalemia is working.

Choice C rationale

Sodium polystyrene sulfonate does not directly affect glucose levels. While it’s important to monitor glucose levels in patients with kidney disease, changes in glucose would not indicate whether treatment for hyperkalemia is working.

Choice D rationale

Sodium polystyrene sulfonate does not directly affect ammonia levels. While elevated ammonia levels can occur in certain conditions, such as liver disease, changes in ammonia levels would not indicate whether treatment for hyperkalemia is working.

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Correct Answer is D

Explanation

The correct answer is D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak levels measure the highest concentration of the drug in the bloodstream, typically drawn immediately after completion of the infusion.
Trough levels measure the lowest concentration, typically drawn 30 minutes before the next scheduled dose to ensure effective drug levels while preventing toxicity.

Why the other options are incorrect:

A. One hour after completion of the IV dose and one hour before the next administration – Waiting one hour for the peak level could lead to an inaccurate measurement, as the drug may already be metabolized or distributed.
B. Two hours after completion of the IV dose and two hours before the next administration – This timing is too late for both peak and trough levels, missing the best points for measurement.
C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration – The sample drawn mid-infusion does not represent peak levels, making this method ineffective.

Key takeaway:

Peak and trough monitoring for vancomycin is essential to maximize effectiveness while avoiding nephrotoxicity and ototoxicity. Proper timing ensures accurate therapeutic drug monitoring.

A. Instruct the patient to exhale rapidly into the mouthpiece when using the discus. B. Explain that the patient should not use the discus more than twice daily. C. Inform that patients using the discus may experience a decrease in blood pressure. D. Suggest offering the discus to the patient for use during an acute asthma attack.

Correct Answer is B

Explanation

Choice A rationale

Instructing the patient to exhale rapidly into the mouthpiece when using the discus is incorrect. The patient should breathe in through their mouth as deeply as they can until they have taken a full deep breath.

Choice B rationale

Fluticasone and salmeterol is a combination of two medicines that are used to help control the symptoms of asthma and improve breathing. It is used when a patient’s asthma has not been controlled sufficiently on other asthma medicines, or when a patient’s condition is so severe that more than one medicine is needed every day. Therefore, explaining that the patient should not use the discus more than twice daily is the correct instruction.

Choice C rationale

Informing that patients using the discus may experience a decrease in blood pressure is incorrect. The most common side effects of fluticasone and salmeterol include drowsiness, dizziness, and weakness.

Choice D rationale

Suggesting offering the discus to the patient for use during an acute asthma attack is incorrect. Fluticasone and salmeterol is not used to relieve an asthma attack that has already started.

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The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving intravenous vancomycin, and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times would provide the best determination of these levels?

Correct Answer is D

Explanation

Explanation:

Why the other options are incorrect:

Key takeaway:

A patient in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system to manage asthma.This system delivers an inhaled powdered form of these combined medications. What instruction should the nurse provide to this patient’s caregivers?

Correct Answer is B

Explanation

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